Wiki drug allowable lower than cost

[abranch13]

We are starting to see several of our drugs we use for injections have a lower allowable from Medicare than the cost we are paying to the manufacturer. Are we just stuck with what Mediare allows and lose money on the injection, or is there some way to get Medicare to pay a higher reimbursement to cover the cost? Any help is appreciated!

Thanks

 

[Pam Warren]

First question--are you billing the appropriate # of units per billable dosage? That may account for the discrepancy.

But if your billing is spot on, and you are a Medicare provider taking assignment, you have to take the full adjustment.

Try to negotiate with your supplier, and certainly discuss with your MAC.